Donor Egg IVF

Egg donor IVF is a fertility treatment option for those who can’t use their own eggs, for whatever reason. Especially when using a screened egg donor (as opposed to a family member or friend), the success rates for egg donor IVF are good—higher than the average IVF success rates for couples not using a donor.

While egg donor IVF means the intended mother will not be genetically related to her child, the intended father will be. (Unless a sperm donor is also being used.) This makes it more attractive of an idea than embryo donor IVF. With an embryo donor, neither intended parent would be genetically related to the child.

Gay male couples interested in family building with IVF will also require an egg donor. In this case, one of the intended fathers will be genetically related to the child. (Assuming they don’t use a sperm donor.) A surrogate would be required to carry the pregnancy and give birth to the child.

When Egg Donor IVF Is Needed

In conventional IVF treatment, the woman takes fertility drugs to stimulate egg production in her ovaries. Once the eggs reach maturity, they are retrieved via an ultrasound-guided needle.

The retrieved eggs are placed in a petri dish with sperm cells, and hopefully, some eggs are fertilized. The resulting embryos can then either be transferred to the mother’s uterus, transferred to a surrogate’s uterus, or frozen for a later cycle.

But what if the intended mother’s ovaries aren’t producing enough eggs for regular IVF? Or what if the intended mother’s ovaries are completely absent? What if a gay male couple wants to have a child? Then egg donor IVF may be recommended. Here are some situations in which egg donor IVF may be required or recommended.

• Age related infertility (most often for women age 40 or older)
• A single male with a surrogate
• Gay male couple having a child with a surrogate
• Genetic disease risk on female partner’s side
• Low ovarian reserves (indicated by very high FSH levels or a low antral follicle count)
• Primary ovarian insufficiency (also known as premature ovarian failure)
• Post-cancer treatment (if the ovaries or eggs were damaged or removed)
• Repeated canceled IVF treatment due to poor or low ovarian response
• Unexplained repeated IVF failure
• Woman born without her ovaries due to a congenital anomaly

Where to Find an Egg Donor

Your fertility doctor can discuss with you in detail your options for finding an egg donor. That said, there are a number of common sources.

Donor Sources

• A friend or family member
• Another infertile couple willing to share their retrieved eggs
• Egg bank (in this case, frozen eggs)
• Egg donor agency
• Fertility clinic offering you IVF treatment

Depending on the contract you sign, you may get a chance to meet your egg donor. Or, you may never have any contact with them. Some donors will agree to be contacted in the future by the donor-conceived offspring. Before you decide, discuss all of your options with a lawyer familiar with reproductive law as well as an infertility counselor or psychologist.

Egg Donor IVF Process

Here’s a very condensed and basic explanation of what the egg donor IVF process looks like. For the sake of simplicity, the explanation below assumes a heterosexual couple is having a child with the male partner’s own sperm, and the female partner is going to carry the child. It also assumes you’re using “fresh” eggs and not frozen.

Decisions and Logistics

After a reproductive endocrinologist determines that egg donor IVF would be the best option for a couple, the intended parents meet with a psychologist or counselor. They discuss the psychological risks and benefits to egg donor IVF, and decide if this is the right path for them.

The intended parents will also likely meet with a financial advisor at the fertility clinic. Egg donor IVF is very expensive, and they will need to be sure they can afford it, and create a plan on how to get the funds they need.

Once the fertility doctor and a therapist have cleared the intended parents, the next step is finding an egg donor.

The process of finding an egg donor requires time and careful consideration. You may spend months on this step.

Once you find and select a donor—and once they are available for your cycle (there may be a waiting period)—you’ll need to attend to a number of legal and financial matters.

You will need to sign a contract before the cycle can start. This contract is written up and/or reviewed by a lawyer specializing in family reproductive law. Your clinic or agency may offer to “share” a lawyer with you. This is less expensive overall, but you should hire your own legal counsel.

A lawyer who represents the clinic, agency, or donor can’t also fully advocate for you. Each party should have their own legal representation. It’s worth the extra money for the peace of mind.

Before Donation

Once all the legal and financial issues are settled, and the donor and intended mother have completed whatever fertility testing and screening is required for treatment to begin, you’ll start the actual egg donor IVF cycle.

The intended mother and donor will need to have their menstrual cycles put in sync.

This way, when the donor’s fertilized eggs are ready for embryo transfer, the intended mother’s uterus will be physiologically ready to accept an embryo. This means taking birth control pills and usually also injectable hormones that suppress the reproductive system.

Treatment Cycle

Once the donor and intended mother get their periods, the treatment cycle itself will begin. The donor will be taking injectable fertility drugs in order to stimulate egg production. Her cycle will follow very closely to a conventional IVF cycle, skipping the embryo transfer.

The intended mother will give herself injections meant to suppress the reproductive system so the doctor can keep the donor and her in sync. She will also take estrogen supplementation. The estrogen will signal the uterus to create a suitable lining.

When the eggs in the donor’s ovaries look ready, the donor will get an injection of hCG. This is also known as a trigger shot. It will start the last stage of egg maturation. Around this time, the intended mother will start taking progesterone supplementation. Like the estrogen, this helps prepare the uterus for the embryo.

The donor will come into the fertility clinic for the egg retrieval. Egg retrieval is done using an ultrasound-guided needle.

After the egg retrieval is complete, the donor’s active role in the cycle is over.

She will be given home care instructions for recovery from the egg retrieval, and instructions on what to do if she suspects she’s developing ovarian hyperstimulation syndrome (OHSS).

That same day of the egg retrieval, the intended father will provide a semen sample. In some cases, the sample may be prepared and frozen earlier. But it’s usually done on the day of the egg retrieval itself.

The retrieved donor eggs will be put together with the intended father’s sperm cells. Hopefully, some of the eggs will become fertilized. After three to five days, the intended mother will come into the fertility clinic for an embryo transfer.

One to two healthy looking embryos will be transferred into the intended mother’s uterus. Any extra embryos will be frozen—or cryopreserved—for a future cycle.

The intended mother will continue to take progesterone supplementation. About ten days after the embryo transfer, the intended mother will take a pregnancy test to see if the cycle was a success.

Risks

Egg donors face similar risks as women going through conventional IVF. The fertility drugs taken to stimulate the ovaries all come with risks and side effects that the donor must know about.

The biggest risk to the donor is developing OHSS. Because donors are usually young and very fertile, their risk may be slightly higher than an infertile woman going through IVF.

It’s extremely important the donor knows the signs and symptoms of OHSS so it can be dealt with quickly. Untreated OHSS can threaten her fertility and even her life, in rare cases.

There are also psychological risks to the donor. The donor may later regret the decision to donate her eggs, or wonder what happened to the eggs retrieved and/or the child conceived with her help.

That said, many donors experience feelings of satisfaction and pride in helping a family. Speaking to a counselor before donation is extremely important and usually required by egg donor programs.

For the intended mother, the primary risk of donor egg IVF is conceiving a multiple pregnancy. To reduce the risk, as few embryos as possible should be transferred. Talk to your doctor about whether single embryo transfer may be best for your situation.

Success Rates

According to the Center for Disease Control, the live birth rate for donor egg IVF is 55.9% for fresh embryo transfer and 40.2 percent for frozen embryo transfer. This is the nationally reported average for 2013. Success rates will vary from clinic to clinic.

In the case of egg sharing with another infertile couple, the success rate may be lower. The same can be said for using a friend or family member as a donor, who may not be the ideal donor candidate.